We must preserve this synergistic public-private partnership… but we must find ways to improve it further moving forward. I think that NIH resources are best spent in funding all of the fundamental as well as clinical translational research that will allow us to more definitively address the therapeutic and diagnostic approaches we will take in the future.

I really doubt that precious NIH funds are better diverted to discovering or developing drugs, perhaps with some few exceptions… certain orphan diseases or drug to combat bioterrorism, and perhaps some infectious diseases as well.

WOOD—We have a system that incentivizes the development of symptomatic therapies and/or incentivizes the development of therapies for very short treatments: antibiotics… painkillers, and other symptomatic therapies. We’ve moved now into a situation in which we’re developing drugs to prevent diseases. We’re developing drugs to be taken for a lifetime.

And politicians, academics and drug companies have done a very poor job of articulating that for the public… One of the reasons prescription drugs are a much more major part of our health care dollar today is that we don’t just take 10 days of an antibiotic…

We need to explain to people that the ideal model of health care would put surgeons and anesthesiologists out of work, and we would treat diseases by pills. You know, (the doctor) on Star Trek didn’t do much surgery. He waved things at people and people swallowed things and so on… We’re going to have to redesign the model of the ’50s, if you will…

And the reason that’s important, is that whereas in a model where you’re treating symptoms or disease in an individual, you can much more easily understand and articulate the risk/benefit ratio for that patient, when you’re preventing a disease, you never ever know the patient benefited from the drug, ever. But you always know the patient who developed an adverse event.

PAUL: I think it starts with society understanding… what benefit/risk actually means. It’s become clearer to me, given my experience in the industry, but I’m not sure it’s clear to the average citizen.

All drugs have benefits and risks that manifest differently among patients. It is critical that patients and doctors fully understand these risks—and carefully monitor for side effects or the usually rarer serious adverse events that can occur with virtually all drugs.